In this article, we will delve into polycythaemia in detail.
What is polycythaemia?
Polycythaemia refers to an increased concentration of red blood cells in the blood. This condition makes the blood denser and less capable of moving through blood vessels and organs efficiently. Many symptoms of polycythaemia are due to the slow flow of blood.
What are the symptoms of polycythaemia?
Not everyone with polycythaemia experiences symptoms, but many do.
Symptoms include:
- Headache
- Blurred vision
- Reddening of the skin, especially in the face, hands, and feet
- Feeling tired
- High blood pressure
- Dizziness
- Abdominal discomfort
- Confusion
- Bleeding issues, such as nosebleeds and bruising
- Gout, which may cause joint pain, stiffness, and swelling
- Itchy skin, especially after showering
What are the causes and risk factors for polycythaemia?
There are two main types of polycythaemia:
- Primary polycythaemia: This occurs when there is a problem in the cells produced by the bone marrow that eventually become red blood cells; the most common type is called polycythemia vera (PV).
PV is considered rare, typically caused by a change in the JAK2 gene, leading to an excessive production of red blood cells by bone marrow cells.
Infected bone marrow cells can also develop into other types of blood cells, meaning that people with PV may also have abnormally high numbers of both platelets and white blood cells.
- Secondary polycythaemia: This results from a condition that causes a high number of red blood cells. It can also be due to low oxygen levels in the blood (caused by smoking, living at high altitudes, or chronic exposure to smoke). This is done to compensate for the low oxygen levels in the blood.
What are the diagnostic methods?
Polycythaemia is diagnosed through medical history, clinical examination, and certain tests, as determined by the treating doctor, such as:
- Red blood cell count in the blood
- The space occupied by red blood cells in the blood (hematocrit level)
A high concentration of red blood cells indicates polycythaemia.
Sometimes, polycythaemia is only detected during routine blood tests conducted for other reasons.
A doctor might refer the patient to a hematologist (a blood disorder specialist) for further testing to confirm the diagnosis and pinpoint the underlying cause.
These tests may include:
- A blood test to check for a changed JAK2 gene
- Kidney function tests
- An abdominal ultrasound to identify kidney problems
What are the treatment methods for polycythaemia?
The goal of treating polycythaemia is to prevent symptoms and complications (like blood clots) and to address any underlying causes.
Blood removal:
Removing blood is the simplest and fastest way to reduce red blood cell count. It may be recommended if the patient has polycythemia vera, a history of blood clots, or symptoms indicating excessively thick blood. This process involves removing half a liter of blood at a time, similar to donating blood.
Medication to slow red blood cell production:
A medication to prevent blood clotting:
Low-dose aspirin tablets may be prescribed daily for people with polycythemia vera to help prevent blood clots and reduce the risk of serious complications.
How to prevent polycythaemia?
Adopting some healthy lifestyle changes can reduce the risk of serious blood clots in individuals with all types of polycythaemia.
Having polycythaemia means a person is already at risk for blood clots, and being overweight or smoking compounds this risk.
The following advice and information may be helpful to avoid developing polycythaemia:
- Lose weight
- Maintain a healthy weight
- Prevent cardiovascular disease
- Manage high blood pressure
- Quit smoking
What are the complications of polycythaemia?
Many cases are mild and may not lead to other complications. However, in some cases, particularly of polycythemia vera, it can be more severe and require long-term treatment. Those with polycythemia vera have a slightly reduced life expectancy due to the increased risk of problems, such as heart attacks and strokes.
Polycythaemia can also cause blood clots that put the patient at risk for conditions like:
- Pulmonary embolism: A blockage in the blood vessels transporting blood from the heart to the lungs
- Deep vein thrombosis (DVT): A blockage that forms in the leg veins before moving to another part of the body
When should you consult a doctor?
Seek immediate medical attention if you exhibit signs of deep vein thrombosis or pulmonary embolism, which include:
- Pain, swelling, redness, and tenderness in one of your legs
- Severe pain in the affected area
- Warmth in the area of the clot
- Shortness of breath
- Chest or upper back pain
- Coughing up blood
- Feeling dizzy
- Faint
Polycythaemia also increases the risk of heart attacks and strokes. Seek emergency medical assistance if you think you are having a heart attack or stroke.
Frequently Asked Questions
Is polycythaemia a chronic, untreatable disease?
There are some secondary causes for an increase in red blood cells, such as smoking in its various forms, living at high altitudes, and chronic smoke exposure from frequently using fireplaces and wood stoves. By addressing and reducing these causes, with God's will, red blood cells can return to their normal levels.
